|Year : 1981 | Volume
| Issue : 3 | Page : 217-220
P Siva Reddy, Sham Sunder Gupta
Sarojini Devi Eye Hospital, Hyderabad, India
P Siva Reddy
Sarojini Devi Eye Hospital Hyderabad
|How to cite this article:|
Reddy P S, Gupta SS. Anterior keratotomy. Indian J Ophthalmol 1981;29:217-20
Recently Prof. Fyodrov of U.S.S.R. developed a new surgical procedure for correcting myopia. He called it as "Dissection ligmentum circulatum of the cornea". It is popularly known as Anterior Keratotomy. He has shown a series of electron microscopic slides on the histology of cornea which revealed that there is circular ligment of the cornea situated in the limbus extending round the circumference of the cornea situated at the level of deep stromal layers. This is made use of in the operation called "Anterior Keratotomy". He explains that following inluxing of this legiment after making radial cuts leaving pupillary zone free, there will be flattening of cornea. Hence there will be reduction in the corneal curvature. Thus it reduces the Myopia.
| Materials and methods|| |
The study of myopic surgery, (Anterior Keratotomy) was undertaken at the Institute of Ophthalmology, Sarojini Devi Eye Hospital, Hyderabad. The cases selected for the Myopic surgery are :
- Simple Myopia.
- Non-progressive type of myopia. -
- Wearing a constant number of glasses for atleast a minimum period of 2 years.
- Refraction ranging from -3 to -8 Diaptors were selected.
- Young and Adolescents were chosen.
- Progressive type of myopia, too young and too old were not selected for study.
All the cases were investigated thoroughly before surgery and followed after surgery.
Under this study, Anterior Keratotomy was done in 60 myopic eyes during a period of 12 months each (eye is taken as one case). The cases were followed post operatively every day for two weeks thereafter at weekly intervals for about four months. They were later followed every month for the rest 9 months.
| Surgery|| |
Operation is performed, using operating microscope, and the procedure is simple and can be done under local anaesthesia. On an average 16 to 18 incisions were given on the cornea extending from the pupillary zone to limbus. Size of the trephine also varies with the degree of myopia ie., greater the degree of myopia smaller the diameter of the trephine.
| Observations|| |
These are Summarized in [Table - 1][Table - 2][Table - 3][Table - 4][Table - 5].
| Discussion|| |
The advantages of this operation are :
- Operation is very simple and easy to perform.
- Practically there are no complications.
- Simple instruments are required(4).
- About 16 incisions were given on the cornea extending from the pupillary zone to the limbus.
- There is a dramatic improvement of visual acuity in the first and second weeks. Later it slowly comes down in 40% of the cases; and nearly 60% of the cases vision was retained between 6/6 and 6/12.
- The cornea becomes flatter by 1 to 2mm in the first and second weeks and this flatness gradually decreased.
- The incisions made on the cornea do not affect either the field of vision or accommodation and convergence.
- There is no change in the corneal thickness, and sensations.
- Change in the refraction is between -3 to -4 DS ph. myopia.
Personally I feel that this operation though gives good results immediately after operation the vision that has been gained without glasses has not been maintained for long periods. We require further explanation and experience before this procedure is accepted as treatment.
This operation has not been followed anywhere in the world except in the Soviet Union that too in only one institution.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5]